Insurance Reimbursement Supervisor (3 days @ home, 2 in office)

SUMMARY:

The Insurance Reimbursement Supervisor works alongside the Insurance Reimbursement and Patient Financial Specialist. They will work with the team to ensure the collection of and to maximize revenue opportunities through daily/regular oversight of the team by ensuring consistent follow-up and/or appeal of unpaid, partially paid or denied claims.They will also work alongside the Director of Revenue to effectively monitor and report on billing metrics and strategic revenue opportunities.They will work alongside the EPIC Specialist Team and Director of Revenue to build revenue rules for an improved billing process. They will monitor collection and accounting of payer revenues including but not limited to the billing of all claims, collections and follow-up on existing accounts receivables.

Neighborcare Health offers a robust benefit package including Health, Wellness & Retirement benefits: Medical, Dental & Vision Insurance, 18+ days of Paid Time Off, 9-Paid Holidays, Retirement with Matching, Life & AD&D, Pet Insurance, Employee Assistance Program, & More! This position is eligible for the Staff Referral Program

KEY RESPONSIBILITIES: 

• Supervise and mentor the Insurance Reimbursement and Patient Financial Specialist Teams

• Accurately decipher denial reason and prospectively plans follow-up steps utilizing the electronic billing system
• Collection efforts for primary, secondary, or tertiary Insurances, which include calling commercial and government insurance companies
• Provide oversight at all levels of an insurance appeal
• Provide training, guidance and direction to direct reports
• Monitor and review Aged A/R
• Review and process Write Off Requests
• Monitor Productivity Reports
• Partner with Director of Revenue and internal departments to resolve business issues that may affect collection activities
• Responsible for ensuring that all payer correspondence is distributed and handled in a timely manner.
• Review managed care contracts to determine correct reimbursement for each account
• Submit written appeals for underpayments to insurance companies
• Tracks, recognize trends and analyzes ways to fix/reduce payer denials and rejections. 
• Call insurance companies to check on the status of unpaid claims
• Works on and tracks outgoing and incoming correspondence from insurance companies
• Understands and follows all federal, state, and local payer-billing requirements.
• Print and re-file claims as needed
• Answer incoming patient and insurance company phone calls as received
• Ensure all accounts are worked from work queues with proficiency and 95% accuracy
• Assist the team to meet individual quality and quantity performance goals
• Make independent decisions that require individual and/or team analysis, reasoning, and problem solving.
• Knowledge and understanding of the healthcare revenue cycle
• Knowledge and understanding of CPT4, ICD10 and HCPC coding
• Understanding and knowledge of insurance plans pertaining to contractual adjustments and discounts
• Excellent customer service skills
• Perform other duties as assigned

SUPERVISORY: 

• Develop effective and efficient staffing schedules that are sensitive to productivity, workflow requirements
• Audit operational processes and counsel/train staff as needed.
• Supports staff efforts in the resolution of customer service and billing issues
• Recommends and implements changes to Billing Coding policies and procedures as necessary.
• Performs regular review of regulations governing the billing of patient services and organizational billing practices.

KEY SKILLS: 

• Ability to adhere to Neighborcare Health policy and procedures
• Ability to be detail oriented and to problem-solving
• Research Insurance Denials
• Ability to interpret and discuss an insurance explanation of benefits and payments
• Ability to meet and comply with HIPAA/Confidentiality policies and procedures
• Ability to organize, problem solve, and work under pressure independently to meet critical deadlines
• Ability to demonstrate predictable, reliable and timely attendance
• Knowledge of Managed Care, Medicare and Medicaid guidelines
• Extensive working knowledge of billing and collections for Medicare, Medicaid and commercial payers.
• Skill in time management
• Basic Accounting Skills
• Basic knowledge in Microsoft Word and Excel
• Strong attention to detail
• Knowledge and understanding of policies and procedures governing credit balance analysis and resolution of provider contracts with